DELHI PUBLIC SCHOOL

R.N. Extension Meerut Road, Ghaziabad

Registration Form 2018 - 2019

Note: All ‘*' marked fields are mandatory. Please mention 'NA’ if not applicable.

Sibling Details:

Sibling (Real Brother/ Sister) only studying in DPS R.N Extension

Admission No.

Sibling Name

Sibling Class

Student Details:

Class Applied For*

Student First Name*

Middle Name

Last Name*

Gender*

Date of Birth*

Place of Birth

Blood Group

Child's Nationality*

Only child of the Parent

Caste Category* (Submission of Certificate at the time of admission is a must)

Religion*

Minority*

Handicap*

Category *

Transport Category

If by bus, choose the student picking point :

Communication Details:

Email*

Mobile No. for SMS: *

Previous School Attended

Details:

Name of The School With City Name :

School Recognized By

Year of Passing Last Class

Medium of Instruction Till Now

Details of The Performace of The Child in 2016-2017 (Not Applicable For NUR & PREP)

S.No.

Subject

Marks

Grade

Grade Point

Achievements in Previous School

1

ENGLISH

2

HINDI

3

MATHEMATICS

4

SCIENCE

5

SOCIAL SCIENCE

Parental Information

Father Details:

Name*

Staff No

Academic Qualifications*

Occupation*

Designation

Organisation

Phone(Off.)

Phone(Resident)

Address(Off.)

Residential Address*

E-mail*

Mobile no.*

Gross Annual Income*

City*

Pin Code

Mother Details:

Name*

Staff No

Educational Qualification*

Occupation*

Designation

Organisation

Phone(Off.)

Phone(Resident)

Address(Off.)

Residential Address

E-mail

Mobile no.*

Annual Income

Pin Code

Guardian's Details:

In case the parents are not residing with the child*

First Name

Middle Name

Last Name

Relationship With The Child

Occupation

Designation

Phone(Off.)

Phone(Resident)

Residential Address

Pin Code

E-mail

Mobile no.

I Agree

DECLARATATION:I. I UNDERSTAND THAT THE REGISTRATION FEE IS NON REFUNDABLE & I FULLY UNDERSTAND THAT REGISTRATION IS NOT A GUARANTEE FOR ADMISSION. ADMISSION IS GRANTED ONLY WHEN THERE IS AN EXISTING VACANCY AND THE CHILD FULFILS THE ELIGIBILITY CRITERIA.II. IN CASE MY CHILD/WARD IS ADMITTED, THE SCHOOL MAY MAKE ARRANGEMENTS FOR INOCULATIONS AGAINST TYPHOID AND CHOLERA & VACCINATION AGAINST SMALL POX TO MY CHILD FROM THE SCHOOL DOCTOR.III. I HAVE MADE A CAREFUL NOTE OF THE VARIOUS DETAILS REGARDING THE PAYMENT OF SCHOOL FEES. I HAVE MADE SATISFACTORY ARRANGEMENTS FOR REMITTANCE OF SCHOOL FEES WITHIN WAITING FOR A REMINDER FROM THE SCHOOL. I WILL PAY THE SCHOOL FEE THROUGH CROSSED CHEQUES/DRAFTS IN FAVOUR OF DELHI PUBLIC SCHOOL INDIRAPURAM, MEERUT ROAD CAMPUS AS PER RULE. WITHDRAWAL OF STUDENTS AFTER REMITTANCE OF FULL FEE IN SCHOOL ACCOUNT WOULD BE THE SOLE DISCRETION OF THE GUARDIAN. I FULLY UNDERSTAND THAT IF A CHILD IS WITHDRAWN AFTER PAYING THE FULL FEES, THE FEES WILL NOT BE REFUNDED.IV. I HEREBY CERTIFY THAT THE DATE OF BIRTH & SPELLING OF THE NAME OF MY CHILD/WARD GIVEN IN THIS FORM ARE CORRECT TO THE BEST OF KNOWLEDGE AND I SHALL NOT MAKE ANY REQUEST FOR CHANGE.V. I UNDERSTAND THAT RENDERING FALSE OR MISLEADING INFORMATION OR WITHHOLDING CORRECT INFORMATION MAY DISQUALIFY THE CHILD FOR ADMISSION/EDUCATION AT THIS SCHOOL.VI. I CERTIFY THAT I AM A BONAFIDE GUARDIAN OF THE CHILD.VII. HAVING CAREFULLY READ THE RULES, REGULATIONS AND PROCEDURES LAID DOWN IN THE SCHOOL PROSPECTUS AND BEING DESIROUS OF HAVING MY CHILD/WARD EDUCATED IN DELHI PUBLIC SCHOOL INDIRAPURAM, MEERUT ROAD CAMPUS, GHAZIABAD, I HEREBY AGREE TO ABIDE BY THEM IN ALL RESPECTS. I UNDERSTAND THAT THE DECISION OF THE MANAGEMENT OF THE SCHOOL SHALL BE FINAL, BINDING AND ACCEPTABLE TO ME.VIII. I HEREBY CERTIFY THAT MY CHILD/WARD AND MYSELF SHALL FOLLOW ALL THE RULES, REGULATIONS & PROCEDURES LAID DOWN BY SCHOOL FROM TIME TO TIME.IX. I UNDERSTAND THAT THE FEES MAY INCREASE ACCORDING TO THE INCREASE IN LIVING INDEX AS PER DECISION OF THE MANAGEMENT. A 10% INCREASE IN FEES IS EXPECTED EVERY YEAR.X. I HEREBY PUT MY SIGNATURE TO CONFIRM THE ABOVE DECLARATIONS.